| NPI | 1104884725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 118202) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-28076) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-02-09 |